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Family conflict is an established predictor of psychopathology in youth. Traditional approaches focus on between-family differences in conflict. Daily fluctuations in conflict within families might also impact psychopathology, but more research is needed to understand how and why. Using 21 days of daily diary data and 6-times a day experience-sampling data (N = 77 participants; mean age = 21.18, SD = 1.75; 63 women, 14 men), we captured day-to-day and within-day fluctuations in family conflict, anger, anxiety, and sadness. Using multilevel models, we find that days of higher-than-usual anger are also days of higher-than-usual family conflict. Examining associations between family conflict and emotions within days, we find that moments of higher-than-usual anger predict higher-than-usual family conflict later in the day. We observe substantial between-family differences in these patterns with implications for psychopathology; youth showing the substantial interplay between family conflict and emotions across time had a more perseverative family conflict and greater trait anxiety. Overall, findings indicate the importance of increases in youth anger for experiences of family conflict during young adulthood and demonstrate how intensive repeated measures coupled with network analytic approaches can capture long-theorized notions of reciprocal processes in daily family life.
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OBJECTIVE: A holistic understanding of the naturalistic dynamics among physical activity, sleep, emotions, and purpose in life as part of a system reflecting wellness is key to promoting well-being. The main aim of this study was to examine the day-to-day dynamics within this wellness system. METHODS: Using self-reported emotions (happiness, sadness, anger, anxiousness) and physical activity periods collected twice per day, and daily reports of sleep and purpose in life via smartphone experience sampling, more than 28 days as college students ( n = 226 young adults; mean [standard deviation] = 20.2 [1.7] years) went about their daily lives, we examined day-to-day temporal and contemporaneous dynamics using multilevel vector autoregressive models that consider the network of wellness together. RESULTS: Network analyses revealed that higher physical activity on a given day predicted an increase of happiness the next day. Higher sleep quality on a given night predicted a decrease in negative emotions the next day, and higher purpose in life predicted decreased negative emotions up to 2 days later. Nodes with the highest centrality were sadness, anxiety, and happiness in the temporal network and purpose in life, anxiety, and anger in the contemporaneous network. CONCLUSIONS: Although the effects of sleep and physical activity on emotions and purpose in life may be shorter term, a sense of purpose in life is a critical component of wellness that can have slightly longer effects, bleeding into the next few days. High-arousal emotions and purpose in life are central to motivating people into action, which can lead to behavior change.
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Emoções , Sono , Adulto Jovem , Humanos , Autorrelato , Exercício Físico , EstudantesRESUMO
Curiosity promotes learning. Two open questions concern the extent to which tobacco smokers exhibit curiosity about smoking-related health information and whether this curiosity can facilitate recall of this information. Participants (n = 324 smokers; n = 280 nonsmokers) performed a Trivia Guessing Task wherein participants guessed the answers to general trivia and smoking-related trivia questions and provided ratings of their curiosity prior to viewing the answers to the questions. A subset of participants (n = 121 smokers; n = 97 nonsmokers) completed a surprise Trivia Memory Task one-week later and answered the previously-viewed questions. Results indicate that smokers are no less curious about smoking-related trivia than they are about general trivia and that curiosity about the answer to smoking-related trivia is associated with more accurate recall of smoking-related trivia answers one week later. Findings suggest that engendering states of curiosity for smoking-related information may facilitate retention of that information in smokers.
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Comportamento Exploratório , Nicotiana , Humanos , Fumantes , Rememoração Mental , AprendizagemRESUMO
OBJECTIVE: To determine how the dual-task nature of incorporating physical activity with instructional activities immediately impacts acuity of the approximate number system and on-task behavior in preschoolers. METHODS: Using a randomized within-participants repeated-measures crossover design, 51 children completed an approximate number system task before and after either 20-min of physically active instruction corresponding to 38% heart rate reserve (HRR; light-to-moderate intensity) or conventional sedentary instruction at corresponding to 21% HRR (very light intensity). RESULTS: Findings revealed that preschool-aged children exhibited similar learning and greater on-task behavior following a single bout of physically active instruction relative to conventional sedentary instruction. Overall, preschoolers accrued 931.3 ± 8.2 more steps and an additional 9 minutes at or above light-intensity activity during the physically active instruction. CONCLUSION: Accordingly, these findings suggest that the dual-task nature of physically active learning does not compromise learning, reduces the need for redirecting off-task behavior, and ultimately allows children to avoid sedentary behavior in educational contexts.
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Atenção/fisiologia , Comportamento Infantil/fisiologia , Exercício Físico/fisiologia , Aprendizagem/fisiologia , Pré-Escolar , Estudos Cross-Over , Feminino , Humanos , MasculinoRESUMO
While compelling evidence indicates that poorer aerobic fitness relates to impairments in retrieving information from hippocampal-dependent memory, there is a paucity of research on how aerobic fitness relates to the acquisition of such relational information. Accordingly, the present investigation examined the association between aerobic fitness and the rate of encoding spatial relational memory-assessed using a maximal oxygen consumption test and a spatial configuration task-in a sample of 152 college-aged adults. The findings from this investigation revealed no association between aerobic fitness and the acquisition of spatial relational memory. These findings have implications for how aerobic fitness is characterized with regard to memory, such that aerobic fitness does not appear to relate to the rate of learning spatial-relational information; however, given previously reported evidence, aerobic fitness may be associated with a greater ability to recall relational information from memory.
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This commentary highlights 23 noteworthy publications from 2018, selected by leading scientists in pediatric exercise science. These publications have been deemed as significant or exciting in the field as they (a) reveal a new mechanism, (b) highlight a new measurement tool, (c) discuss a new concept or interpretation/application of an existing concept, or (d) describe a new therapeutic approach or clinical tool in youth. In some cases, findings in adults are highlighted, as they may have important implications in youth. The selected publications span the field of pediatric exercise science, specifically focusing on: aerobic exercise and training; neuromuscular physiology, exercise, and training; endocrinology and exercise; resistance training; physical activity and bone strength; growth, maturation, and exercise; physical activity and cognition; childhood obesity, physical activity, and exercise; pulmonary physiology or diseases, exercise, and training; immunology and exercise; cardiovascular physiology and disease; and physical activity, inactivity, and health.
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Together, data from brain scanners and smartphones have sufficient coverage of biology, psychology, and environment to articulate between-person differences in the interplay within and across biological, psychological, and environmental systems thought to underlie psychopathology. An important next step is to develop frameworks that combine these two modalities in ways that leverage their coverage across layers of human experience to have maximum impact on our understanding and treatment of psychopathology. We review literature published in the last 3 years highlighting how scanners and smartphones have been combined to date, outline and discuss the strengths and weaknesses of existing approaches, and sketch a network science framework heretofore underrepresented in work combining scanners and smartphones that can push forward our understanding of health and disease.
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Psiquiatria , Smartphone , Humanos , Psicopatologia , Encéfalo/diagnóstico por imagemRESUMO
Modifying behaviors, such as alcohol consumption, is difficult. Creating psychological distance between unhealthy triggers and one's present experience can encourage change. Using two multisite, randomized experiments, we examine whether theory-driven strategies to create psychological distance-mindfulness and perspective-taking-can change drinking behaviors among young adults without alcohol dependence via a 28-day smartphone intervention (Study 1, N = 108 participants, 5492 observations; Study 2, N = 218 participants, 9994 observations). Study 2 presents a close replication with a fully remote delivery during the COVID-19 pandemic. During weeks when they received twice-a-day intervention reminders, individuals in the distancing interventions reported drinking less frequently than on control weeks-directionally in Study 1, and significantly in Study 2. Intervention reminders reduced drinking frequency but did not impact amount. We find that smartphone-based mindfulness and perspective-taking interventions, aimed to create psychological distance, can change behavior. This approach requires repeated reminders, which can be delivered via smartphones.
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Alcoolismo , COVID-19 , Humanos , Adulto Jovem , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/prevenção & controle , Alcoolismo/psicologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias , Distância PsicológicaRESUMO
For undergraduate students, excessive screen time is associated with poorer mental health and greater perceived stress. Objective: The purpose of the present investigation was to determine the potential moderating influence of physical activity and sleep on the relationship between screen time and stress. Participants & Methods: A cross-sectional sample of 513 undergraduate students between Fall 2017 & Spring 2020 were given a questionnaire to assess perceived stress level, physical activity engagement, screen time, and sleep. Results: Stepwise hierarchical regression analyses identified that screen time, sleep, and the three-way interaction between screen time, sleep, and physical activity were associated with stress. Post-hoc decomposition revealed that higher levels of physical activity and sleep both mitigated the relationship between screen time and stress. Conclusions: Findings suggest that modifiable health behaviors such as physical activity and sleep may be important factors for managing the negative effects of screen time on stress in college-aged adults.
HighlightsExcessive screen time is associated with higher levels of stress.Cross-sectional sample of 513 college-aged young adults.Adiposity and aerobic fitness were unrelated to stress.In high active individuals, screen time is unrelated to stress.In low active individuals, greater sleep attenuates the screen time-stress relationship.
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Background: The waxing and waning of negative affect in daily life is normative, reflecting an adaptive capacity to respond flexibly to changing circumstances. However, understanding of the brain structure correlates of affective variability in naturalistic settings has been limited. Using network control theory, we examine facets of brain structure that may enable negative affect variability in daily life. Methods: We used diffusion-weighted imaging data from 95 young adults (age [in years]: mean = 20.19, SD = 1.80; 56 women) to construct structural connectivity networks that map white matter fiber connections between 200 cortical and 14 subcortical regions. We applied network control theory to these structural networks to estimate the degree to which each brain region's pattern of structural connectivity facilitates the spread of activity to other brain systems. We examined how the average controllability of functional brain systems relates to negative affect variability, computed by taking the standard deviation of negative affect self-reports collected via smartphone-based experience sampling twice per day over 28 days as participants went about their daily lives. Results: We found that high average controllability of the cingulo-insular system is associated with increased negative affect variability. We also found that greater negative affect variability is related to the presence of more depressive symptoms, yet average controllability of the cingulo-insular system was not associated with depressive symptoms. Conclusions: Our results highlight the role that brain structure plays in affective dynamics as observed in the context of daily life, suggesting that average controllability of the cingulo-insular system promotes normative negative affect variability.
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BACKGROUND: Aerobic fitness relates to superior math achievement, but the underlying reasons remain unclear. This study tested how more efficient processing (efficiency hypothesis) or enhanced allocation of cognitive resources (resources hypothesis) underly fitness-related differences in arithmetic cognition in a sample of 138 college-aged adults. METHOD: Participants completed an arithmetic task while pupillary measures were recorded prior to an aerobic fitness test. RESULTS: Higher aerobic fitness was associated with shorter reaction time for all problems and greater pupillary reactivity for problems requiring approximate and exact arithmetic. CONCLUSIONS: Superior aerobic fitness relates to greater cognitive resources available to execute exact and approximate arithmetic faster. Fitness-related differences in math achievement may be driven by the cognitive resources underlying arithmetic strategy. These differences may extend beyond educational achievement and affect the motivation to engage in health behaviors based on quantitative information. Thus, improving cardiovascular fitness has the potential to also ameliorate health numeracy.
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Cognição , Exercício Físico , Logro , Adulto , Escolaridade , Humanos , Matemática , Adulto JovemRESUMO
Aerobic fitness is consistently and robustly associated with superior performance on assessments of cognitive control. One potential mechanism underlying this phenomenon is activation of the locus-coeruleus. Specifically, individuals with greater aerobic fitness may be better able to sustain engagement in a cognitively demanding task via a superior ability to meet the metabolic demands of this neural system. Accordingly, the present investigation examined 1) the relationship between aerobic fitness and phasic activation of the locus-coeruleus (indexed using pupillometry) and 2) the potential mediating influence of locus-coeruleus activity on the relationship between aerobic fitness and cognitive task performance. Participants performed an inhibition task while their pupillary responses were measured using an infrared eye tracker. A VO2max test was then performed to determine individuals' aerobic fitness levels. Consistent with previous research, higher levels of aerobic fitness were related to shorter reaction time. However, phasic activity of the locus-coeruleus did not mediate this relationship - nor did it relate to aerobic fitness level. These results suggest that aerobic fitness does not relate to differences in locus-coeruleus activity in the context of cognitive control in college-aged adults.
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Exercício Físico , Locus Cerúleo , Adulto , Cognição , Humanos , Inibição Psicológica , Aptidão Física , Tempo de Reação , Adulto JovemRESUMO
BACKGROUND: Providing physical activity during the school day may mitigate increasingly sedentary lifestyles among children. Young children may be susceptible to interference during learning and consolidation when performing physical activity concurrently with academic instruction. METHODS: Preschoolers (N = 72, mean age 5.1 ± 0.8 years, 50% female) completed a quantity estimation task before, following, and one week after engaging in either a 20-min physically active or sedentary lesson. Physical activity intensity and volume were measured using heart rate and pedometer step counts, respectively. Off-task behavior was recorded prior to and following the lesson. RESULTS: Children exhibited similar learning and retention, but an added benefit of physically active lessons was a 1900% step increase and a 58% reduction in off-task behavior. CONCLUSION: Providing physically active lessons instead of sitting for extended periods of time in early childhood classrooms reduces sedentary behavior and improves self-regulation while not interfering with educational outcomes.
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Aprendizagem Baseada em Problemas , Autocontrole , Criança , Pré-Escolar , Exercício Físico , Feminino , Humanos , Masculino , Educação Física e Treinamento , Comportamento SedentárioRESUMO
Determining the sensitivity and specificity of short neurocognitive assessments to objectively detect concussion will help clinicians more confidently integrate such tools in clinical management decisions. This study quantified the sensitivity and specificity of a computerized cognitive flexibility task isolating shifts of visuospatial attention in combination with clinical symptoms acutely (< 72 h) following concussion. A total of 100 athletes (53 concussed; 47 non-injured control; 42% female) completed computerized neurocognitive testing and clinical symptom reports (Sport Concussion Assessment Tool 3rd edition: SCAT3). Separate discriminant function analyses were performed for individual, combination, and stepwise inclusion of neurocognitive and clinical symptomology assessments. Findings revealed the combination of neurocognitive outcomes (i.e., mean reaction time, response accuracy, and response accuracy cost) with clinical symptom factor scores exhibited the greatest sensitivity (95.7%) and specificity (88.7%) as well as the highest positive predictive value (95.9%) and negative predictive value (88%) relative to other approaches. Further, a stepwise approach predicting concussion status using the discriminant functions improved detection of concussion (98.2% sensitivity, 95.7% specificity, 96.4% positive predictive value, and 97.8% negative predictive value) when clinical symptom factors failed to indicate the presence of a concussion. Incorporating a cognitive flexibility task involving shifts of visuospatial attention combined with clinical symptom factor scores may improve clinical decision-making as this approach exceeds the sensitivity and specificity of widely popular neurocognitive test batteries and takes less than 10 min to administer.
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Traumatismos em Atletas , Concussão Encefálica , Atletas , Traumatismos em Atletas/complicações , Traumatismos em Atletas/diagnóstico , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Cognição , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Instituições AcadêmicasRESUMO
Rinsing the mouth with a carbohydrate solution has been suggested as a means to enhance aspects of both physical and cognitive performance. However, evidence in support of these assertions is relatively weak. The purpose of this study was to investigate the effects of a carbohydrate mouth rinse solution on motor speed, inhibition, and sustained attention as indexed by both behavioral and neuroelectric measures. Using a double-blind, placebo-controlled, within-subjects crossover design, 50 college-aged young adults performed a battery of cognitive tasks both before and after rinsing their mouth for 10 s with 20 mL of either a carbohydrate mouth rinse solution or a sensory-matched placebo control solution. A simple tapping task was used as a measure of motor speed, a modified Eriksen flanker task was used to index inhibition, and a rapid visual information processing task was used as a measure of sustained attention. Participants demonstrated longer reaction times in the Flanker task after rinsing their mouths with the carbohydrate mouth rinse, relative to pretest. No differences in reaction time were observed for the placebo control condition. P3 latency in the Flanker task as an index of attentional processing speed was shorter at posttest than at pretest in the placebo control - but not the carbohydrate mouth rinse - condition. These results suggest that despite claims of cognitive enhancement, carbohydrate mouth rinses do not appear to alter motor speed, inhibition, or sustained attention as compared to a placebo control in non-physically-fatigued college-aged adults.
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Atenção/efeitos dos fármacos , Carboidratos/farmacologia , Potenciais Evocados/efeitos dos fármacos , Inibição Psicológica , Antissépticos Bucais/farmacologia , Desempenho Psicomotor/efeitos dos fármacos , Tempo de Reação/efeitos dos fármacos , Adulto , Método Duplo-Cego , Eletroencefalografia , Potenciais Evocados P300/efeitos dos fármacos , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Objective: The primary purpose of this study was to examine the longitudinal effects of sports-related concussion (SRC) on a multi-faceted assessment battery which included neuropsychological testing, symptom reporting, and enhanced brain function index (eBFI) among athletes with and without SRC. A secondary purpose was to explore longitudinal sex differences among these measures in athletes with and without SRC. Methods: A case-control, repeated-measures design was used for this study. A total of 186 athletes (concussed group:n= 87 controls:n= 99) participated in the study. A repeated-measures design was used in which each athlete was tested at four time points following an SRC: within 72 h of injury (Day 0; 2.0 ± 0.9 days following injury), 5 days following injury (Day 5; 5.0 ± 0.0), at return to play (RTP; 18.3 ± 13.8 days following injury), and within 45 days following RTP (RTP45; 66.2 ± 19.0 days following injury). All analyses were conducted separately using a 2 (Group: concussed, control) × 2 (Sex: male, female) × 4 (Time:Day 0, Day 5, RTP, RTP45) univariate multi-level model including the random intercept for each participant. A higher eBFI score indicates a better performance. Alpha level was set aprior at .05. This study was registered on clinicaltrials.gov (Objective Brain Function Assessment of mTBI/Concussion in College/high school Athletes NCT02477943, NCT02661633, CAS 13-25 NCT03963804). Results: Concussed athletes exhibited impaired eBFI within 72 h of SRC and at Day 5 compared to controls (p<.001). Analysis of eBFI scores between male and female athletes revealed a main effect of sex (p=.05), with female athletes exhibiting lower eBFI (33.9 ± 30.7) relative to male athletes (40.4 ± 33.0), however, it did not indicate interactions between sex, group, and time (p's ≥ 0.786). Conclusion: The eBFI appears to be a useful tool in determining concussed athletes during the acute stages of an SRC. However, this index may lack the sensitivity to detect sex-related differences between groups at various time points during recovery.
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Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/fisiopatologia , Concussão Encefálica/diagnóstico , Concussão Encefálica/fisiopatologia , Adolescente , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Eletroencefalografia , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Caracteres Sexuais , UniversidadesRESUMO
Single bouts of exercise have been observed to enhance numerous domains of cognition including inhibitory aspects of cognitive control and neuroelectric indices of attention. Given that the locus-coeruleus norepinephrine system regulates alertness and attention, this system may underlie these exercise-induced enhancements. The present study used pupillometry to examine the extent to which a single bout of exercise induces changes in aspects of locus-coeruleus activation, as well as the extent to which changes in locus-coeruleus activation were associated with changes in inhibition and neuroelectric indices of attention. Using a within-participants crossover design, behavioral, neuroelectric, and pupillometric measures were assessed in response to an inhibitory control task before and after 20-min of either aerobic exercise or an active-control condition during two separate, counterbalanced sessions. The aerobic exercise condition consisted of walking/jogging on a motor driven treadmill at an intensity of approximately 70% of age-predicted maximum heart rate. The active control condition consisted of walking on the treadmill at 0.5 mph and 0% grade. Replicating prior findings, enhancements in both reaction time and neuroelectric indices of attention were observed in response to the exercise condition. However, neither the exercise nor the active control conditions were observed to induce changes in activation of the locus-coeruleus as indexed by pupil size, and changes in activation of the locus-coeruleus were not associated with exercise-induced changes in inhibition and neuroelectric indices of attention. Accordingly, these findings provide evidence to suggest that activation of the locus-coeruleus is not a mechanism underlying exercise-induced enhancements in cognition.
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Exercício Físico/fisiologia , Locus Cerúleo/fisiologia , Tempo de Reação/fisiologia , Reflexo Pupilar/fisiologia , Adolescente , Estudos Cross-Over , Exercício Físico/psicologia , Feminino , Humanos , Inibição Psicológica , Masculino , Adulto JovemRESUMO
Extant evidence demonstrates disruptions to inhibitory control from as little as six months to as long as several years following sports-related concussion. However, the sensitivity of tasks requiring inhibitory control for detecting disruptions to cognition during the acute, subacute, and protracted phases of recovery remains in question. Accordingly, the purpose of this study was to examine concussion-related disruptions to inhibitory control across recovery. Athletes with sports-related concussion (nâ¯=â¯55; 22 female) completed an inhibitory control task within 72â¯h of injury, after returning to play, and within one month following return to play. Matched control athletes (nâ¯=â¯55; 22 female) were tested at similar intervals. Behavioral indices of performance were analyzed using univariate multi-level modeling. Findings indicated that the concussion group exhibited decrements to inhibitory control immediately after injury and up to one month following return to play, with no such observable differences at the return to play period. In addition to being sensitive to detecting chronic cognitive deficits resulting from sports-related concussion, these findings suggest that inhibitory control measures have the requisite sensitivity to identify the immediate and protracted signs of neurocognitive dysfunction following sports-related concussion. Accordingly, integrating assessments of inhibitory control into baseline, post-injury, and post-season measurement of cognitive function may prove useful for tracking the acute and persistent effects of sports-related concussion across an athlete's career. Athletes exhibiting impaired inhibitory control across the phases of recovery may be at greater risk of reinjury, thereby suggesting that integrating inhibitory control assessments into existing clinical measures may be of interest for informing concussion management and return-to-play decisions.
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Traumatismos em Atletas/psicologia , Concussão Encefálica/psicologia , Função Executiva/fisiologia , Inibição Psicológica , Adolescente , Atletas , Cognição/fisiologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Volta ao Esporte , Adulto JovemRESUMO
Compelling evidence supports an association between the attribute of aerobic fitness and achievement scores on standardized tests of reading. However, such standardized assessments provide only a broad valuation of a complex network of language related sub-processes that contribute to reading and are heavily confounded by other attention-related processes. The present investigation sought to clarify the nature of the association between aerobic fitness and language processing in a sample of college-aged adults. Participants were bifurcated based on aerobic fitness level and on a separate day were asked to complete a lexical decision task while neuroelectric activity was recorded. Analysis of word-level language-related ERP components revealed no fitness differences. However, lower aerobically-fit individuals elicited smaller amplitude for attention-related ERP components relative to the higher aerobically-fit group. These data provide initial evidence to suggest that fitness-related differences in reading achievement may result from attentional processes rather than acting upon specific language-related processes.
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Atenção/fisiologia , Cognição/fisiologia , Idioma , Aptidão Física/psicologia , Leitura , Adulto , Tomada de Decisões , Eletroencefalografia , Potenciais Evocados , Feminino , Humanos , Masculino , Análise e Desempenho de Tarefas , Adulto JovemRESUMO
OBJECTIVE: A critical barrier to the understanding of disruptions to cognitive flexibility following sports-related concussion is the use of assessments that conflate shifts of visuospatial attention and contextual rules. Because these dissociable forms of cognitive flexibility are subserved by distinct neural networks, the utility of a cognitive flexibility assessment following concussion may be reduced, depending upon the extent to which the task requires shifting visuospatial attention relative to shifting contextual rules. Accordingly, the current investigation examined the extent to which these aspects of cognitive flexibility exhibit differential trajectories of recovery following a sports-related concussion. METHOD: Twenty-two athletes with sports-related concussions were assessed on a cognitive flexibility task with 2 switch conditions (i.e., perceptual-based and contextual rule-based) within 72 hr of injury, after return to play, and within 1 month following return to play. Thirty-three healthy control athletes were tested at the same intervals. RESULTS: Findings revealed that concussed athletes demonstrated protracted disruptions in task performance on a visuospatial attention-based cognitive flexibility task relative to healthy controls, whereas disruptions in task performance on a contextual rule-based cognitive flexibility task resolved after the acute phase of injury. These findings suggest that dissociable forms of cognitive flexibility exhibit differential trajectories of recovery. CONCLUSIONS: Therefore, evaluations detecting sports-related concussion disruptions in cognitive flexibility may be reduced depending on the extent to which they rely on contextual rule-based decisions. Test batteries focusing on visuospatial attention-based demands may be useful additions to aid in the objective assessment and follow-up management of athletes following the acute phase of injury. (PsycINFO Database Record